Department of Surgery, University Hospital of Larissa, Larissa, 41110, Viopolis, Greece.
Obes Surg. 2012 Mar;22(3):411-5. doi: 10.1007/s11695-011-0436-8.
Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure, and data regarding the learning curve are scarce. The aim of this study is to assess how the procedure can be safely implanted in a newly established bariatric unit and to define the learning curve.
Proctorship and mentorship in bariatric surgery were attended by two surgeons who were previously experienced in advanced laparoscopic surgery. The first consecutive 102 patients who underwent LSG in our newly established bariatric center were included. Patients were divided into three groups of 34 (groups 1, 2, and 3) according to case sequence. Data on demographics, operative time, conversion rate, hospital stay, morbidity, mortality, and excess weight loss (EWL) over time were compared between the groups.
The operative time was significantly lower in groups 2 (p = 0.016) and 3 (p = 0.003) compared to group 1. The learning curve was flat up to the 68th case. A significant decrease in hospital stay was noted for group 3 compared to groups 1 (p < 0.001) and 2 (p = 0.002). The conversion rate, mortality and morbidity rates, and EWL did not differ significantly between the groups. Mortality was 0.98% and procedure-related morbidity was 7.8%.
LSG can be safely and efficiently performed in a newly established bariatric center following a mentorship procedure. Proficiency seems to require 68 cases. The operative time and hospital stay may significantly decrease with experience early in the learning curve, as opposed to mortality and morbidity rates, conversion rate, and EWL.
腹腔镜袖状胃切除术（LSG）是一种相对较新的减重手术，关于学习曲线的数据很少。本研究旨在评估该手术如何在新成立的减重中心安全植入，并定义学习曲线。
两位在高级腹腔镜手术方面经验丰富的外科医生参加了减重手术的指导和指导。纳入了在我们新成立的减重中心接受 LSG 的前 102 例连续患者。根据病例顺序将患者分为三组，每组 34 例（第 1、2 和 3 组）。比较了各组之间的人口统计学数据、手术时间、转化率、住院时间、发病率、死亡率和随时间推移的超重损失（EWL）。
与第 1 组相比，第 2 组（p = 0.016）和第 3 组（p = 0.003）的手术时间明显降低。学习曲线在第 68 例时趋于平坦。与第 1 组（p < 0.001）和第 2 组（p = 0.002）相比，第 3 组的住院时间明显减少。转化率、死亡率和发病率以及 EWL 在各组之间没有显着差异。死亡率为 0.98%，与手术相关的发病率为 7.8%。
在新成立的减重中心，LSG 可以在指导程序后安全有效地进行。熟练程度似乎需要 68 例。与死亡率和发病率、转化率和 EWL 相比，手术时间和住院时间可能会随着学习曲线早期的经验而显着减少。
